Abstract:
INTRODUCTION:Limited data are available describing indications for and outcomes of therapeutic plasma exchange (TPE) in cardiac transplantation. METHODS:In a retrospective study of patients who underwent cardiac transplantation at Duke University Medical Center from 2010 to 2014, we reviewed 3 TPE treatment patterns: a Single TPE procedure within 24 h of transplant; Multiple TPE procedures initiated within 24 h of transplant; and 1 or more TPE procedures beginning >24 h post-transplant. Primary and secondary outcomes were overall survival (OS) and TPE survival (TS), respectively. RESULTS:Of 313 patients meeting study criteria, 109 (35%) underwent TPE. TPE was initiated in 82 patients within 24 h, 40 (37%) receiving a single procedure (Single TPE), and 42 (38%) multiple procedures (Multiple TPE). Twenty-seven (25%) began TPE >24 h after transplant (Delayed TPE). The most common TPE indication was elevated/positive panel reactive or human leukocyte antigen antibodies (32%). With a median follow-up of 49 months, the non-TPE treated and Single TPE cohorts had similar OS (HR 1.08 [CI, 0.54, 2.14], P = .84), while the Multiple and Delayed TPE cohorts had worse OS (HR 2.62 [CI, 1.53, 4.49] and HR 1.98 [CI, 1.02, 3.83], respectively). The Multiple and Delayed TPE cohorts also had worse TS (HR 2.59 [CI, 1.31, 5.14] and HR 3.18 [CI, 1.56, 6.50], respectively). Infection rates did not differ between groups but was independently associated with OS (HR 2.31 [CI, 1.50, 3.54]). CONCLUSIONS:TPE is an important therapeutic modality in cardiac transplant patients. Prospective studies are needed to better define TPE's different roles in this patient population.
journal_name
J Clin Apherjournal_title
Journal of clinical apheresisauthors
Onwuemene OA,Grambow SC,Patel CB,Mentz RJ,Milano CA,Rogers JG,Metjian AD,Arepally GM,Ortel TLdoi
10.1002/jca.21622subject
Has Abstractpub_date
2018-08-01 00:00:00pages
469-479issue
4eissn
0733-2459issn
1098-1101journal_volume
33pub_type
杂志文章abstract::For therapeutic plasma exchange (TPE), continuous flow separators are known to be efficient as exemplified by Fresenius AS104 and COBE Spectra. The AS104 uses an interface monitoring system in the centrifuge during TPE, whereas Spectra uses computer algorithms to establish the plasma-cell interface. To determine the p...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.1014
更新日期:2001-01-01 00:00:00
abstract::Plasma replacement for thrombotic thrombocytopenic purpura (TTP) is accomplished with various plasma products. This study sought to determine the incidence of allergic reactions with FFP or CPP as replacement in therapeutic plasma exchange (TPE). Forty-one TTP patients were identified retrospectively who received TPE ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.1025
更新日期:2001-01-01 00:00:00
abstract::Extracorporeal photopheresis (ECP) has been shown to be clinically effective in the treatment of many T cell-mediated conditions. ECP's mechanism of action includes the induction of apoptosis and the release of pro-inflammatory cytokines. Recently, we have observed early lymphoid apoptosis, detectable immediately post...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.10039
更新日期:2002-01-01 00:00:00
abstract::An improved method for intermittent-flow erythrocytapheresis in patients with sickle cell disease is reported. The method, a modification of the standard red cell exchange procedure for the Haemonetics 30S unit, dilutes with physiologic saline the patient's blood as it flows from the draw line and before it reaches th...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920030203
更新日期:1986-01-01 00:00:00
abstract::Therapeutic plasma exchange (TPE), a form of extracorporeal therapy, has been used in the management of many systemic conditions some of which include the systemic vasculitides that affect the kidneys. The following is a mini review of what is known about renal related indications for TPE in such conditions and the ev...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/jca.20306
更新日期:2011-01-01 00:00:00
abstract::Thrombopoietin (TPO) serum levels in 14 patients (9 male and 5 female, mean age 36 years, range 16 to 55 years) with breast cancer (n = 5), testicular cancer (n = 7), or lymphoma (n = 2), undergoing high dose chemotherapy with peripheral blood stem cell (PBSC) transplantation, were evaluated at the first day of the mo...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/(sici)1098-1101(1999)14:2<57::aid-jca2>3.0
更新日期:1999-01-01 00:00:00
abstract::Lipoprotein apheresis is applied to deplete low density lipoprotein and other apolipoprotein B containing lipoproteins in patients with severe familial hypercholesterolemia, hypertriglyceridemia associated pancreatitis, or lipoprotein (a)-hyperlipoproteinemia. Anticoagulation of the extracorporeal circuit may influenc...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21519
更新日期:2017-12-01 00:00:00
abstract::Although rituximab (RTX) is a promising therapeutic agent for treating steroid-resistant nephrotic syndrome (SRNS) resistant to various immunosuppressive agents, some patients have shown resistance to RTX. We report the case of a patient with RTX-resistant nephrotic syndrome and SRNS who was successfully treated with ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21613
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Myeloid-derived leucocytes, a major source of inflammatory cytokines, play an important role in the exacerbation of ulcerative colitis (UC). Selective depletion of myeloid leucocytes by adsorptive granulomonocytapheresis (GMA) with an Adacolumn should alleviate inflammation and promote remission. However, th...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21787
更新日期:2020-08-01 00:00:00
abstract::In-line leukocyte reduction filters (LRF) are available for use with an automated plateletpheresis (PPH) system. Initially, 62% of PPH units produced with such a filter (LRF6, N = 29) had postfiltration (POF) white blood cell (WBC) counts < 5 x 10(6), with a mean POF WBC of 42 x 10(6). In an attempt to decrease POF WB...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920100204
更新日期:1995-01-01 00:00:00
abstract::Plerixafor in combination with granulocyte-colony stimulating factor (G-CSF) is approved for autologous stem cell mobilization in poor mobilizing patients with multiple myeloma or malignant lymphoma. The purpose of this study was to evaluate efficacy and safety of plerixafor in an immediate rescue approach, administra...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21496
更新日期:2017-08-01 00:00:00
abstract::Thrombotic thrombocytopenic purpura (TTP) is a rare but severe disorder characterized by hemolytic anemia, thrombocytopenia, fever, renal failure, and neurologic manifestations. Plasma exchange is the most effective treatment for this condition reducing mortality from 90% in untreated patients to 10%. However, infecti...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20119
更新日期:2007-01-01 00:00:00
abstract::Blood group incompatibility remains a significant barrier to kidney transplantation. Approximately, one-third of donors are blood group incompatible with their intended recipient. Options for these donor-recipient pairs include blood group incompatible transplantation or kidney paired donation. However, the optimal pr...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21390
更新日期:2015-12-01 00:00:00
abstract::Graphite furnace atomic absorption spectroscopy was used to demonstrate a fivefold increase in the median plasma aluminium levels of four patients undergoing therapeutic plasmapheresis. This plasma aluminium loading resulted from contamination of albumin incorporated in the replacement fluids and took place during its...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920030306
更新日期:1987-01-01 00:00:00
abstract::The recent introduction of low-density lipoprotein (LDL)/very low-density lipoprotein (VLDL) selective-removal systems offers an alternative to plasma exchange (PE). For the last 10 years, we have treated a male homozygous hypercholesterolemia type IIA patient with PE using 5% normal serum albumin (NSA) replacement, P...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920070206
更新日期:1992-01-01 00:00:00
abstract::Mobilization regimens for CD34+ cells have generally been judged successful based on the number of cells collected without evaluating mobilization separately from collection. Using retrospective data for patients who collected CD34+ cells on Total Therapy protocols 3a/3b (VTD-PACE) and Total Therapy 4/5 using a novel ...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21313
更新日期:2014-10-01 00:00:00
abstract::This study examined the incidence and predictors of peripheral blood stem cell (PBSC) mobilization failure in patients with multiple myeloma (MM). Retrospective data for 104 patients who received granulocyte colony-stimulating factor (G-CSF) alone or with cyclophosphamide as mobilization regimens were analyzed. The ra...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21326
更新日期:2014-12-01 00:00:00
abstract::We sought to optimize direct intravenous infusion of calcium gluconate (CaGlu) for maintaining plasma ionized calcium concentration ([Ca2+ ]) and preventing hypocalcemic reactions during 34 consecutive 1-volume therapeutic plasma exchanges (TPEs) in eight patients. CaGlu, 2 g in 50 mL of 0.9% NaCl, was prepared by our...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21742
更新日期:2019-12-01 00:00:00
abstract::We have reviewed our initial experience with a program of concurrent collection of plasma (CCP) during plateletpheresis, which was instituted to increase the number of units of fresh frozen plasma produced by our hospital-based donor service. Sixty percent of eligible donors (1,006 of 1,682) participated in CCP, and 2...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920090207
更新日期:1994-01-01 00:00:00
abstract::We have recognized marked effectiveness for intermittent claudication with low-density lipoprotein (LDL) apheresis in two cases of arteriosclerosis obliterans (ASO). The Case 1 was a 73-year-old man with intermittent claudication of both lower extremities (Fontaine class II), digital subtraction angiography (DSA) reve...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20138
更新日期:2007-01-01 00:00:00
abstract::Dysmetabolic iron overload syndrome is a rare event causing hepatic impairment with serious long-term side effects. Here, we describe a case of metabolic syndrome-related hepatic iron overload that showed a rapid, effective, and safe response to erythrocytapheresis. J. Clin. Apheresis 31:443-447, 2016. © 2015 Wiley Pe...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21434
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Autoimmune disorders and neurodegenerative disorders take a physical and emotional toll on patients that undergo therapeutic plasma exchange (TPE) treatments. Previous literature has shown that these patients may feel a greater sense of self-burden. Motivational Interviewing (MI) is a technique used in vario...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21645
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Hereditary thrombotic thrombocytopenic purpura, also called Upshaw-Schulman syndrome (USS), is a rare disease caused by genetic mutations in the ADAMTS13 gene, which severely decrease the activity of ADAMTS13, a metalloprotease that cleaves von Willebrand factor multimers (VWF). Genotypically identical patie...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21664
更新日期:2019-02-01 00:00:00
abstract::We describe the case of a 24 year old male with severe fistulating Crohn's disease who failed mutliple modalities of medical and surgical therapy. We present objective and subjective evidence of disease remission after induction and maintenance treatment with leukocyte apheresis. This is the first described case of su...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21308
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Patients undergoing therapeutic plasma exchange (TPE) may present with risks for hemorrhage or thrombosis. Use of replacement fluids devoid of coagulation factors will decrease factor levels and platelet levels. There are no established guidelines for hemostasis management in these situations. MATERIALS AND...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21653
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:A red cell exchange was performed to prevent a potentially fatal hemolytic transfusion reaction in a patient with anti-e who was transfused with e-antigen unscreened red blood cells during liver transplant surgery. CASE REPORT:A 64-year-old woman with cirrhosis due to hepatitis C was scheduled to receive a liv...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.21461
更新日期:2017-02-01 00:00:00
abstract::Apheresis procedures in small children are technically challenging and require special planning with attention to extracorporeal volume. Discontinuous procedures such as extracorporeal photopheresis (ECP) require additional consideration. Alternative methods to perform ECP have been utilized in small children that req...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.20231
更新日期:2010-01-01 00:00:00
abstract::Idiopathic inflammatory demyelinating diseases (IIDDs) of the central nervous system, of which multiple sclerosis is the prototype, represent a family of monophasic, recurrent or progressive diseases with overlapping clinical and pathological manifestations. While most patients recover spontaneously or following a bri...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章,评审
doi:10.1002/(sici)1098-1101(1999)14:3<144::aid-jca7>3.
更新日期:1999-01-01 00:00:00
abstract::Therapeutic leukapheresis can control the white blood cell count (WBC) of pregnant women with chronic myelogenous leukemia (CML) who have hyperleukocytosis without leukostasis. The medical justification for this treatment has not been objectively documented. We report a 27-year-old woman, diagnosed with CML at 10-week...
journal_title:Journal of clinical apheresis
pub_type:
doi:10.1002/jca.21410
更新日期:2016-08-01 00:00:00
abstract::Modern techniques of mechanical hemapheresis have made it possible to selectively remove vast quantities of lymphocytes and plasma immunoglobulins, and the concentration of these substances in donor blood can fall below the normal range. It is feared that this may lead to immunosuppression; a condition associated in s...
journal_title:Journal of clinical apheresis
pub_type: 杂志文章
doi:10.1002/jca.2920020112
更新日期:1984-01-01 00:00:00